Diferencia entre revisiones de «Interstitial lung disease»
(Category added. References changed - need to be cited in the body text)
Línea 52: Línea 52:


==References==
==References==
* <Bradley B, et al. Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society. Thorax 2008; 63 Suppl 5:v1./>
<references/>
* <Pipavath S, Godwin JD. Imaging of interstitial lung disease. Clin Chest Med 2004; 25:455./>
 
* <Martinez FJ, Flaherty K. Pulmonary function testing in idiopathic interstitial pneumonias. Proc Am Thorac Soc 2006; 3:315./>
[[Category:Pulmonary]]
* <Schwartz M, King Jr TE. Interstitial Lung disease, 5th ed, People's Medical Clearing House, Shelton, CT 2011./>
* <Raghu G, et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med 2011; 183:788./>
* <Garcia CK, Raghu G. Inherited interstitial lung disease. Clin Chest Med 2004; 25:421./>

Revisión del 23:45 28 sep 2017

Background

  • General group of diseases that involve the lung parenchyma
  • Grouped together because of similar clinical, physiologic, radiographic, or pathologic findings
  • Specific diseases separated into ones with known causes and idiopathic
  • Treatment and prognosis differs between specific diseases
  • Examples of specific diseases: interstitial pneumonia, hypersensitivity pneumonitis, cryptogenic organizing pneumonia, acute interstitial pneumonitis, sarcoidosis, idiopathic pulmonary fibrosis

Clinical Features

  • Symptoms: progressive exertional dyspnea, persistent nonproductive cough, hemoptysis, pleuritic chest pain
  • History of occupational exposure: asbestosis, silicosis
  • Abnormal chest imaging or pulmonary function tests
  • Take detailed history making sure to focus on past medical history (connective tissue disease, inflammatory bowel disease, malignancy), smoking history, family history, medications, occupational and environmental exposures
  • Physical exam is generally nonspecific

Differential Diagnosis

  • Pneumonia
  • Asbestosis
  • Berylliosis
  • Pulmonary edema
  • Coal worker's pneumoconiosis
  • Cryptogenic organizing pneumonia
  • Drug induced pulmonary toxicity
  • Farmer's lung
  • Hypersensitivity pneumonitis
  • Interstitial pulmonary fibrosis
  • Collagen-vascular disease
  • Lung malignancy
  • Restrictive lung disease
  • Sarcoidosis
  • Silicosis

Evaluation

Work up and test results differ between types of interstitial lung diseases. Below are common studies obtained to determine disease. See page for specific disease for specific labs/imaging and findings.

  • CBC/CMP
  • Serologic studies: ANA, Rheumatoid factor
  • Imaging: Chest x-ray, chest CT
  • Pulmonary function tests
  • Cardiac ECHO
  • Bronchoalveolar lavage
  • Lung biopsy

Management

  • Management differs between specific types of interstitial lung diseases. This is why it is important to determine specific cause of disease. See specific disease page for management.

Disposition

  • Depending on how stable the patient is, patient can be admitted for work up or discharged for outpatient work up.
  • Important to determine acute vs chronic symptoms.

See Also

References

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